| NPI | 1841456571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: SC 7389) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: NY 029999-1) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2023-06-09 |